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Cost-effectiveness analysis of a rotavirus immunization program for the United States
A W Tucker1, A C Haddix, J S Bresee
1Viral Gastroenteritis Section, Respiratory and Enteric Viruses Branch, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
JAMA
|May 15, 1998
Summary
A national rotavirus immunization program offers significant societal savings by preventing millions of childhood diarrhea cases. While cost-effective for society, the healthcare system requires a lower vaccine price for full cost offset.
Area of Science:
- Public Health
- Health Economics
- Vaccinology
Background:
- Rotavirus is a leading cause of severe diarrhea in children globally.
- A live, oral rotavirus vaccine is nearing licensure for pediatric use.
- Economic evaluation is crucial for assessing the impact of new public health interventions.
Purpose of the Study:
- To estimate the economic impact of a nationwide rotavirus immunization program in the United States.
- To analyze cost-effectiveness from both healthcare system and societal perspectives.
Main Methods:
- A decision tree model was employed to analyze cost-effectiveness.
- Estimates of disease burden, vaccine coverage, efficacy, and price were sourced from published data.
- The proposed vaccine schedule involved administration at 2, 4, and 6 months of age.
Main Results:
- A universal rotavirus immunization program is projected to prevent over 1 million diarrhea cases in the first five years of life.
- The program is estimated to avoid 34,000 hospitalizations and 95,000 emergency department visits.
- At $20 per dose, the program results in a net societal savings of $296 million but a net loss to the healthcare system; break-even prices are $9 (healthcare) and $51 (societal).
Conclusions:
- A US rotavirus immunization program is cost-effective from a societal viewpoint.
- For the healthcare system, cost-effectiveness is achieved if the vaccine price is $9 per dose or lower.
- Increased disease burden, vaccine efficacy, and reduced vaccine price enhance cost-effectiveness.